Clinical medicine (London, England)
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The current Ebola virus disease (EVD) outbreak ravaging three nations in West Africa has affected more than 14,000 persons and killed over 5,000. It is the longest and most widely spread Ebola epidemic ever seen. ⋯ What lessons can we learn from Nigeria, Senegal and Ghana in the current epidemic? How can the world improve the health systems in low- and middle-income countries to effectively manage future outbreaks? Recently, the Royal College of Physicians launched a new partnership with the West African College of Physicians to curtail the effects of HIV/AIDS, malaria and tuberculosis in the region. We believe that strengthened health systems, skilled human resources for health and national ownership of problems are key to effective management of outbreaks such as EVD.
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Team assessment of behaviour (TAB) is the multi-source feedback assessment of professional behaviours that all UK foundation doctors must engage in twice during their two-year programme. TAB can identify the few underperforming trainees and provide feedback to consolidate the good practice of most. For optimum validity, TAB must be undertaken by a range of assessors, as specified in the national UK Foundation Programme curriculum. ⋯ Introduction of validity checking before sign-off greatly improved the numbers of valid assessments in 2011. This was partially sustained in 2012. Assurance of assessment validity is important to ensure delivery of appropriate constructive feedback and to allow early detection and remediation of signs of poor professional behaviours in foundation doctors.
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From senior school through to consultancy, a plethora of assessments shape medical careers. Multiple methods of assessment are used to discriminate between applicants. ⋯ We review the evidence for non-knowledge-based tests and discuss their perceived benefits. We raise the question: is the current use of non-knowledge-based tests within the UK at risk of undermining more robust measures of medical school and postgraduate performance?
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Viral infections are the commonest cause of encephalitis, and the purpose of this article is to inform UK clinicians of the presentation, diagnosis and management of viral encephalitis in travellers returning to the UK. The classical presentation is as a triad of fever, headache and altered mental state. ⋯ This, coupled with the fact that untreated herpes simplex encephalitis (HSE) has a mortality of over 70%, means that aciclovir should always be included in the treatment of patients with suspected encephalitis, regardless of their history of travel. In the UK, the Rare and Imported Pathogens Laboratory (RIPL) at Public Health England can perform specific polymerase chain reaction (PCR) analyses on blood and CSF samples for many imported causes of viral encephalitis.